Urban Pandemic Preparedness

The total number of infectious disease outbreaks and the diversity of pathogens have increased over the past few decades. Urbanization, directly and indirectly, contributes to the risk of infectious disease and promotes disease emergence in urban populations by providing conditions ideal for the amplification and transmission of disease. Furthermore, because cities are dominant hubs of global travel and commerce, including for voluntary and forced migrants, the risk of disease transmission between global cities is heightened by the transnational flow of products and people. These trends accelerate the speed at which pathogens can spread around the world.

Although international public health institutions, governments, and civil society groups are making progress in mitigating the health impact of infectious disease outbreaks, the scale of the associated economic and societal disruptions of outbreaks are increasing. In combination, the dynamic realities of urban environments and the mobility human populations contribute to a truth that most future outbreaks will have a substantial urban component. Accordingly, strengthening urban pandemic preparedness represents a compelling opportunity to improve both global health and urban resilience.

Inoculating Cities Books

While global governance systems provide a legal and operational framework for addressing infectious disease threats, their full enforcement and implementation largely depend on the participation of local stakeholders. Municipal leaders and stakeholders are responsible for much of the management of an outbreak – such as quarantine, access to care, distribution of medical countermeasures, and first responders – but little to no attention has been paid to equipping these leaders with the tools they require to successfully mitigate the consequences of disease threats. In this context, Rebecca Katz and Matthew Boyce have co-edited two volumes providing a high-level look at the threats posed to cities by infectious disease outbreaks, as well as in-depth case studies of models of urban pandemic preparedness and response, authored by experts in the field.

Engaging Mayors in Pandemic Preparedness

International and national leaders have worked to develop high-level plans to prepare for pandemics. However, city mayors and other municipal leaders have traditionally not been engaged in these initiatives. This, despite the vital role they play in the response to and recovery from outbreaks. 

Whether acting independently or collaboratively, municipal-level stakeholders have a clear incentive and compelling opportunity to make a meaningful global impact by engaging with pandemic preparedness initiatives. We are working with the Global Parliament of Mayors (GPM) to realize this aspiration and improve pandemic preparedness in cities around the world. 

COVID-19 and the GPM

The rapid spread of the SARS-CoV-2 virus has prompted a collective, global response to the resulting COVID-19 pandemic. In 2018, the Global Parliament of Mayors (GPM), took up the cause of pandemic preparedness and prioritized it as a key component of urban health planning and committed to developing an intra-city mechanism to share information and experiences during an emergency response. In this context, the GPM held a virtual conference on Rethinking the City: How Mayors Respond to the Needs of a Post-COVID City where experts and mayors shared and discussed their visions for an improved post-COVID city and urban agenda. On behalf of the Center for Global Health Science and Security, Matthew Boyce delivered opening remarks that framed the subsequent discussions on public health. Read them here.

Our Publications


Boyce MR, Asprilla MC., van Loenen B., McClelland A., Rojhani A. (2022). Urban pandemic response: survey results describing the experiences from twenty-five cities during the COVID-19 pandemic. PLoS Global Public Health., 2(11):e0000859. DOI:10.1371/journal. pgph.0000859.

Boyce MR, Asprilla MC, van Loenen B, McClelland A, Rojhani A. (2022). How do local-level authorities engage in epidemic and pandemic preparedness activities and coordinate with higher levels of government? Survey results from 33 cities. PLoS Global Public Health, 2(10):e0000650. DOI:10.1371/journal.pgph.0000650.

Boyce MR, Katz R. (2021). COVID-19 and the proliferation of urban networks for health security. Health Policy & Planning, czaa194. DOI:10.1093/heapol/czaa194.

Boyce MR, Katz R. (2020). Rapid urban health security assessment tool: a new resource for evaluating local-level public health preparedness. BMJ Global Health, 5, e002606. DOI:10.1136/bmjgh-2020-002606.

Madad S, Moskovitz J, Boyce MR, … Katz R. (2020). Ready or Not, Patients Will Present: Improving Urban Pandemic PreparednessDisaster Medicine and Public Health Preparedness, 1-4. DOI:10.1017/dmp.2020.7.

Boyce MRKatz RStandley CJ. (2019). Risk Factors for Infectious Diseases in Urban Environments of Sub-Saharan Africa: A Systematic Review and Critical Appraisal of EvidenceTropical Medicine and Infectious Diseases, 4(4), 123. DOI: 10.3390/tropicalmed4040123.

Katz R, Mookherji S, Kaminski M, Haté V, Fischer JE. (2012). Urban governance of disease. Administrative Sciences, 2(2), 135-47. DOI: 10.3390/admsci2020135.

Other Publications

Katz R, Boyce MR. (2020). Providing Resources for Cities to Manage COVID-19. Washington, DC: Georgetown University Global Cities.

Muggah R, Katz R. (2020). How cities around the world are handling COVID-19 – and why we need to measure their preparedness. Cologny: World Economic Forum.

Boyce MR, Osman R, Katz R. (2019). A Research Agenda for Urban Pandemic Preparedness: a Call to Action. Washington: Center for Global Health Science & Security.

Katz R, Boyce MR, Morhard R, et al. (2018). A Mayoral Network for Pandemic Preparedness. Durham: Global Policy Opinion.


Diplomatic Immunity Podcast: Global Health & Global Cities (Season 3, Episode 6)
Rebecca Katz and Matt Boyce joined Kelly McFarland on the Diplomatic Immunity Podcast to discuss the COVID-19 and cities’ responses. On the episode, they talk about the various ways in which city, state, and other local governments have responded to the pandemic, vaccine development, and relative successes and challenges. Listen on Spotify here.


Rapid Urban Health Security Assessment (RUHSA) Tool

Local governments and sub-national authorities are often the first to respond to public health emergencies. The Rapid Urban Health Security Assessment (RUHSA) Tool is a resource designed primarily for local government leaders and policymakers to support public policy, decision making and organization as they prioritize, build, and implement capacities to improve local-level health security. While the RUHSA Tool was not designed to be used in the midst of a public health emergency, it may also be adapted to inform a checklist for prioritizing what capacities and activities a city needs to rapidly develop, or to help focus requests for assistance.

Access the Interactive RUHSA Tool Spreadsheet

Exercises & Toolkits

Materials that have been developed to help mayors, urban health departments, and other municipal preparedness workers to conceptualize or simulate a response to a pandemic.

Case Studies

Detailed descriptions of cities taking the initiative to prevent and control infectious disease outbreaks.


Reportspeer-reviewed literature, and other literature. This domain is a compilation of resources from numerous contributors and contains relevant, up-to-date literature on urban public health and pandemic preparedness materials.